Humerus Anatomic Neck vs. Humerus Surgical Neck

One of the most popular posts on this site was a deep dive into the difference between Pope's Blessing and Claw Hand. Who knew anatomy could be so contentious? Admittedly, today's post is likely much less controversial, but I always found the distinction between the anatomic neck of the humerus and the surgical neck of the humerus to be confusing. Well, prepare yourself for today's shallow dive into the subject. Hopefully this will help clarify the distinction between the two. If it's already clear to you, congratulations - at least one of us will benefit from this exercise!

The anatomic neck of the humerus refers to the location of the physeal plate during development. During growth, bone forms at the physeal plate as the child ages. Once the child reaches maturity, the plate closes, usually during puberty. Different growth plates will close at different ages, with well-characterized ranges known for various bony structures. This pattern of plate closure can be used to assess a child's bone age, which can then be compared to their chronological age to assess for any delay in maturation. Returning to the humerus, the anatomic neck is mostly notable as a defined landmark but has less clinical application.

The surgical neck of the humerus refers to the narrowing of the humerus in the proximal diaphysis. The neck abuts the quadrangular space, a potential space formed by the margins of the triceps, teres minor, teres major, and the medial humerus margin (3 Ts + H, as opposed to the more medial triangular space formed by those same 3 Ts, but no H). Since this region is more prone to fracture, that means fractures in this area are more likely to damage the contents of the quadrangular space, namely the axillary nerve and posterior humeral circumflex artery.

By BDB - You can find the picture here. Traced and colored the picture using adobe illustrator., Public Domain, Link

To memorize the difference between the two, you can try a few different ways. First, A for anatomic comes before S for surgical, and the anatomic neck is more proximal on the humerus than the surgical neck. Second, the surgical neck is more often fractured and more likely to have surgical complications, so the name is associated with its clinical relevance.

And that's pretty much it! For me, learning anatomy was much more helpful when I could attach a narrative about some clinical situation in which that anatomy was relevant. Start with a basic framework of the location from a book like Netter's Anatomy and then search for clinical scenarios that help solidify the terminology in your mind. Hope this helps!

 

Medical Student New Year's Resolutions for 2017

Happy 2017! Hopefully everyone had a restful and happy holiday season. As the new year is upon us, it is commonly a time for resolutions. Some are personal; some, professional. For me personally, here's to cutting out soda! As research has shown, there is a link between sugary drinks and metabolic disease. Hopefully I can make some personal progress in that direction.

What about you? While your personal goals are unique, most likely we all share professional goals as a healthcare professional student. Study harder. Do well on tests. Figure out what we are doing with the 'rest of our lives.' Setting these goals is very important. However, that is only part of the story. A goal is nothing but a destination. What we need is a roadmap to that destination, or a plan. What would that look like? Let's take a look at the three goals mentioned above and see what concrete steps we can take towards them in 2017.

Study Harder

Ah yes, the eternal hope of the conscientious student. Study harder. The goal is omnipresent, but what does it actually mean? You could study more hours. You could isolate yourself as much as possible as you study. Both fit but is that what we want? Not exactly. What most people mean by study harder is actually to study more effectively. This will differ from person to person as everyone learns in a different manner. Some learn better by reading only, others by taking notes, still more by listening / reviewing lecture audio/video. Regardless of how you like to study, there should be two main objectives: studying for mastery, and studying for testing purposes.

Studying for mastery is a component of lifelong learning. This means that after your review, you have a deep, fundamental understanding of the concept. The upfront cost may be more, in terms of time and effort. However, in the long run, this method is more effective because once you master something, you do not have to go back and relearn it. The idea remains embedded in your knowledge base, much like riding a bike. How do you master a topic? The best way I know how is to actually teach the topic. Seek out or create opportunities. Struggling with anatomy? Volunteer to be an anatomy lab TA - the responsibility will force you to either master the material on your own, or seek out help from others so that you are competent enough to teach.


Do Well On Tests

This is also a very generic goal. Aside from a standardized test like USMLE Step 1, every medical school test will be unique. Discussing non-standardized tests first, you can of course try the steps mentioned above, mastering the entire topic. However, sometimes learning everything A to Z just isn't feasible. At this point, it is important to find out what are the objectives the course instructor wants to emphasize. Look at the syllabus, review old tests if available, and ask senior peers. If all that fails, you should *gasp* just ask the instructor what is important. Trust me, they will be happy to see you being pro-active and striving to fully grasp the essence of the material. While you cannot directly ask "What will be on the test?", you can certainly say something like "There is a lot of material to cover. What are the most important points you see students miss in your experience? What is most important practically?" Only a sadist would actively lead you away from material that will come up on the test.

Standardized tests like the USMLE are a different story. For those your best bet is to study common resources like First Aid and do review questions. Lots of review questions (such as Kaplan QBank). Ideally, you want to do these questions in a similar setting to the actual test. For example, if your test is on a Saturday morning at 8am, you went to spend several Saturdays before the test, waking up before 8, figuring out your pre-test routine, and then doing several sections to best simulate what the test will be like. Remember, for people looking at US residencies, your Step 1 score is the biggest objective determinant of how programs will assess you for interviews, for better or worse. Therefore, it behooves you to put as much concerted effort into preparing for this test as possible.

Figure Out My Career

Despite stressing about tests, they will come and go. Ultimately, the tests are simply a means to an end. It is up to you to define what that 'end' is. What type of medical career do you want? Primarily outpatient? Inpatient? Urban vs underserved community? Domestic vs. international? Medical vs. surgical? While some students go into medical school knowing exactly what they want to do, an equal number have no idea. And that's okay! School is a time for exploration. If you have too fixed a mindset, you may miss out on another opportunity that is an even better fit for you. I recommend perusing Iserson's Getting Into A Residency for not only practical tips about applying but also for a framework about how figure out which specialty you should be applying for.

Questions about the process? Please comment below or use the contact page above. Have a fantastic 2017!

Best Stethoscope for Medical Students

Ever wonder what the best stethoscope for medical school is? Before considering specific models, a medical student should consider several factors:

• Quality
• Anticipated Usage
• Comfort
• Cost
• Additional features

Quality

First and foremost, the stethoscope should faithfully reproduce sounds originating from the target organ. While the majority of stethoscope usage is for the heart, the device is also used to auscultate the lungs, abdomen, carotid arteries, and other various structures as indicated. A useful device should perform well across this range of indications. 

Anticipated Usage

Do you foresee using this only for required rotations and no more? Or, do you foresee doing a lot of primary clinical work, or perhaps even becoming a cardiologist? If you anticipate having a long-term relationship with your stethoscope, it is better to invest in a higher quality, more versatile device. 

Comfort

This varies by individual, but if this is something you need to carry around all day, you want to make sure it's lightweight, portable, and sets comfortably in your ears. 

Cost

Medical school is expensive enough. While a stethoscope is a great investment, you want to make sure it is the right one for you. The budding cardiologist is likely to get more out of the extra dollar spent than the future psychiatrist. 

Additional Features

Newer stethoscopes now include various extensions, such as smartphone apps or other technology. Each person will have to decide on their own if such items are necessary. 

In the US, the majority of medical students, residents, and physicians using Littmann stethoscopes by 3M. They perform well and have stood the test of time. The overall most common type is the 3M Littmann Cardiology III: 

Pros: 

• Two-in-one tube design reduces noise interference
• Dual side chestpiece for adult and pediatric patients
• Two tunable diaphragms
• Weight: 15.7 ounces

Cons: Cost

Personally, I have owned a Cardiology III for years and have had zero issues with it. I have never encountered a clinical situation in which the Cardiology III was not up to the task, or felt that I wish I had a different stethoscope. Littmann has released the Cardiology IV, which is very highly reviewed but looks to be mostly evolutionary changes over the III. For the future cardiologist, the Master Cardiology version is a consideration, but likely too advanced for the beginning medical student.

For the more budget conscious student, the next best option is the 3M Littmann Cardiology II SE: 

Unlike the III, the II SE has slightly lower acoustic performance and a shorter warranty. However, it is a more economical choice.

Here is a table with a full comparison of Littmann stethoscopes features:

	Classic II S.E.	Classic III	Master Classic II
Acoustic Performance	7	8	9
Ideal For	Physical Assessment and Diagnosis	Physical Assessment and Diagnosis	Physical Assessment and Diagnosis
Warranty	3 Years	5 Years	3 Years
Chestpiece Design/Material	Double Sided/Machined Stainless Steel	Double Sided/Machined Stainless Steel	Single Sided/Plated and Polished Alloy
Available Colors/Finishes	6 Colors/ 2 Finishes	18 Colors/ 4 Finishes	9 Colors/ 2 Finishes
Tunable Diaphragm	Tunable Diaphragm	Redesigned Single-Piece Tunable Diaphragm on Each Side of the Chestpiece	Tunable Diaphragm
Tube Design	Single Lumen Tubing	Single Lumen Tubing	Single Lumen Tubing
Weight/Length	135 grams, 28"/71cm	150 grams, 27"/69cm	160 grams, 27"/69cm
Made in USA	✓	✓	✓

	Cardiology III	Cardiology IV	Master Cardiology
Acoustic Performance	9	9	10
Ideal For	Cardiology/High Performance	Cardiology/High Performance	Cardiology/High Performance
Warranty	5 Years	7 Years	7 Years
Chestpiece Design/Material	Double Sided/Machine Stainless Steel	Double Sided/Machined Stainless Steel	Single Sided/Cast Stainless Steel
Available Color/Finishes	16 Colors/ 6 Finishes	7 Colors/ Stainless Steel Finish	7 Colors/ 3 Finishes
Tunable Diaphragm	Two Tunable Diaphragms	Redesigned Single-Piece Tunable Diaphragm on Each Side of the Chestpiece	Tunable Diaphragm
Tube Design	Dual Lumen Tubing	Dual Lumen Tubing	Dual Lumen Tubing
Weight/Length	175, 180 grams Available in 22” / 56cm and 27” / 69cm	167, 177 grams Available in 22” / 56cm and 27” / 69cm	175, 185 grams Available in 22” / 56cm and 27” / 69cm
Made in the USA	✓	✓	✓

Source: Amazon 

Have questions about your stethoscope choice? Feel free to contact us using the link at the top of this page. Happy hunting!

The Medical Student's Daily Bag

Much like students of any stripe, medical students often have many items they need to have on their person during their daily sojurns to lecture halls and wards. While this may be a bit dated, my go to bag in medical school was an earlier version of the Targus Checkpoint-Friendly Mobile Elite Laptop Bag. The other items I typically would have in my bag were:

• Littmann Cardiology III Stethoscope - a nice gift from a good friend, and quite useful on wards
• Penlight
• Mobile device - at the time, a Palm Pilot, but these days I would highly recommend an iPad Air 2 due to the wide range of medical apps, light weight, and long battery life. 
• First Aid for the USMLE Step 1 - until I passed at least, haha
• Nalgene water bottle
• Clif Energy Bar - my current fav, but any snack works
• Pens - always get clickable, black ink pens. And always have an extra one because they will get stolen. Trust me. 
• Highlighters
• Pocket Medicine - probably should have carried this more during medical school, but was definitely a must-have during internship, so why not start early?
• Pager - [grumbles]

Aww, I'm getting a little nostalgic thinking about my old bag. Anything you think should be in there that I missed? Please let me know in the comments below!

Medical School Graduation Gifts

It's almost that time of year again, the so-called "Dads & Grads" season for gift buying. However, if you have a special someone graduating from medical school (or PA school or NP school or nursing school etc), the occasion is particularly special. As with past gift guides, the goal is to find a gift that is particularly relevant for someone graduating with a healthcare-related degree. Whether the gift is silly and fun, or more serious and intended to help them form good habits and become an outstanding health practitioner, as always, it's the thought that counts.

This time around, I will try to break the gift guide down by budget: under $25, $25 to $100, and over $100.

Under $20
The always popular Giant Microbes have a wide range of medically-themed plush toys. For example, the budding neurologist or neurosurgeon may appreciate the brain cell:

 

For a more introspective gift, many medical memoirs are available in paperback, including Scrub Notes favorite surgeon/author Atul Gawande:

 

$25 to $100
Love the Giant Microbes, but want more? Get the whole set!

For devices like the iPad suggested below, a Bluetooth keyboard case is an excellent addition. Kensington is a solid brand, and the keyboard case allows use as both a note-taking device and a reader, simply by flipping the cover. The backlit version is particularly useful in dimly lit lecture halls!

Over $100
The budding scholar will need something to port all their notes and knowledge around in. Both for reading as well as for medically related apps, the clear leader is the Apple iPad. With the introduction of the iPad Air and the Mini, the tablets have become small and light enough to carry around all day in a hospital, with the battery life to match. Remote access apps also make it easy to check electronic medical records or imaging remotely when needed. Increasingly, digital devices are becoming the 21st century's stethoscope.

However, the 20th century's stethoscope still remains an essential tool of the clinician as well as a classically stylish gift:

Speaking of classic gifts, a leather doctor's bag certainly fits the bill:

Hopefully these gifts bring a smile to your medical graduate's face. Don't feel like buying something? You could always go the more personal route and either make them something yourself or cook them a nice meal. Have a gift idea that I missed? Please include it in the comments below. Cheers!

How To Become A Plastic Surgeon

Any interest in Plastic Surgery as a specialty? Check out this guest post by Samantha Ferry about the road ahead: 

Medicine is a grueling and incredibly competitive field and, within the field, plastic surgery is among the most competitive routes one can take. Therefore, first and foremost, make sure that you are committed and incredibly passionate before venturing out on the path of pursuing a career in plastic surgery.

Once in college you’ll have to get a bachelor's degree in a premedical major – think biology or chemistry. You must complete all of the required courses for medical school while an undergraduate.

Next, take the Medical College Admission Test (MCAT), and connect with a counselor to narrow down a list of realistic medical schools to apply to. The applications to get into medical school are typically sent out during the senior year of college. Try to look for a school with a plastic surgery residency program as it will make subsequent steps that include specialization considerably easier.

Once in medical school you must graduate with a four-year doctor of medicine (MD) degree (you undergo a third year clinical rotation before choosing a specialty). Once you have your MD degree in tow, you must go through a three-year surgical residency training. Even if you think you’re 100 percent sure that plastic surgery is where your heart lies, it’s a good idea to research the field through the American Board of Plastic Surgery and make sure to do a rotation or externship with a plastic surgeon. These steps will allow you to learn the rules, regulations and the everyday role of a plastic surgeon.

During residency is when you will choose a specialty after completing the general surgery training (think hand surgery, aesthetic surgery). Once your residency is completed, you will need certification with the American Board of Plastic Surgery. However it’s important to note that while the American Board of Plastic Surgery is the oldest certifying body, there are others including the American Board of Cosmetic Surgery.

Some doctors opt to pursue a fellowship after completing their residency before officially beginning their plastic surgery career.

It’s recommended that you seek out job opportunities early on in the last or next to last year of your plastic surgery residency. You’ll also want to remember to network during all of the training as it is key in securing employment opportunities in this very crowded and competitive field. In the same vein you’ll want to attend as many conferences as possible.


Samantha Ferry is a freelancer for AboutPlasticSurgery.com and other medical and health lifestyle websites.

Gifts For Medical Students On Match Day

According to the National Residency Matching Program, Match Day is the day when U.S. medical school soon-to-be graduates will find out what internship and residency programs they have "matched" to, after the several months long interview and ranking process. While graduation is the formal and ceremonial completion of medical training that leads to the conferring of a medical degree, in many ways, the match day is the functional culmination of four years of hard work, or in many cases, a lifelong effort. Friends and family often take part in Match Day ceremonies put on by medical schools to celebrate this major transition point with their loved ones. To help celebrate, here are a few gift ideas for the lucky matchee:

1. A tablet

As technology becomes ever more integrated into medicine, having a tablet is becoming an essential device for staying up-to-date with the latest medical knowledge. Many hospitals now provide free Wifi for their staff, making these tools a highly useful as well as stylish "pocket brain." Tablets can also be utilized for performing clinical calculations or even in evaluating patients in the clinic with the use of specialized apps. In many ways, starting internship or residency is almost like going back to school again... except you are getting paid and likely working harder. Still, might as well be prepared like all the other 'students', right? 

 2. A Little Leisure Reading

             

As well as medical school can prepare a student intellectually for being a practicing physician, there's no substitute for the real thing. All three books above are excellent and describe how the authors made that critical transition in their respective specialties. In fact, the House of God has become so well known that some of the terms coined within entered the general medical lexicon, although usually as kind of an inside joke. 

 3. Or Perhaps Something More Inspirational?

            

When the doldrums of intern year hit (usually around January/February when the novelty has worn off but the light at the end of the tunnel is still somewhat dim, the two books above both provide a big picture look of why we as doctors do what we do. Whether caring for patients in underserved communities in far flung corners of the world or working to turn the arc of a deadly disease, these doctors have made a difference and show us how our daily work is part of the larger whole. Yes, cliche, but sometimes you need those "Hallmark moments" to push you forward as an intern. 

Haha, and if you really want to impress them, buy the Kindle above and preload it with all these titles! That way they can read the book during downtime even at work! 

 4. Something To Make Them Smile

   

And when all else fails, why not try something cuddly? Take it into work and put a smile on the faces of your colleagues and patients!

Looking more ideas? Check out some Match Day gift ideas from years past!


Updated 2015-12-25

Scrub Notes 2012 Med Student Holiday Gift Guide

Happy Thanksgiving! While this is a time to give thanks and count your blessings, tomorrow is a time to shop! However, most med students, residents, and other medical professionals may not be joining on these shopping trips: they're probably studying or on call! So, to celebrate their commitment to caring for others, here are a few ways to show them you care for them:

Kindle Fire by Amazon

The latest tablet from Amazon is quite a break from previous Kindles. Offering an Android-based operating system and full color, the Kindle Fire is Amazon's first foray into the competitive tablet space. While not as full-featured as the iPad, the one killer aspect of the Fire is the price: $199.

That's right, $199 - a full $300 cheaper than the iPad. For med students, the 7" form factor makes it much more portable than the iPad. While lacking 3G support, most students would likely use it in a library or lecture hall (or Starbucks), where Wifi hotspots are plentiful. And with access to Amazon's site well-integrated, it will be easy for them to purchase e-books... or TV shows whenever they need blow off some steam.

Giant Microbes White Blood Cell (Leukocyte)

A popular gift idea last year, the Giant Microbes are back! These stuffed toys are whimsical depictions of all things medical. From bacteria to neurons, check out all the options available. For the immunologically-minded, I put the white blood cell here. I can almost hear him saying, "Meep! A bacteria! Must defend!" Haha, almost like a Pokemon... but one that saves lives!

The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee

This book has been on my reading list all year long and hopefully I can get to it before the year is out. However, from all accounts, the book is well-written and lives up to its subtitle as a biography of cancer. Mukherjee details mankind's history in battling this scourage and how modern science has revolutionized the fight. However, with the great advances come new challenges and new concerns in how we deal with when our bodies fail us.

Looking for more gift ideas? Check out last year's med student gift guide. And if all else fails, you can't go wrong with a gift card =)

Updated 2015-12-20

How New Medical Students Should Learn To Learn

A confusing title, perhaps, but it's correct: newly minted medical students often have to reteach themselves the habit of learning medical knowledge in order to succeed in medical school. This guide from Wellness Rounds, originally intended for students entering Baylor College of Medicine, gives some good pointers for first year medical student study strategies: 

Your goals

1. Learn material for long term retention
2. Pass exams
3. Develop skills for lifelong education & studying (nope, it never stops but it can get faster!)

1. The Basics

• No magic formula for studying except for diligence and consistency
• Goal is to learn and apply pertinent material – NOT perfection
• Efficiency is a skill developed through practice, persistence, and reflection – not the result of drinking more caffeine or a genetic trait that skipped your generation
• Studying is not a competitive sport – some student take (much) less time to learn than you will, but some take (much) MORE time than you…that’s life! Good news – in the end, we are all doctors.
• Be gracious.  To yourself and your peers as you pass through the basic science crucible that brings out some less than pleasant coping mechanisms.  It’s normal and will pass.
• You will succeed!  Don’t believe us some days?  Ask any of the thousands of physicians, professors and mentors around you – we’ll be glad to remind you!

2. The Specifics

• Choose one way to study and stick with it for at at least 1 week
  • Switching study methods costs more time than it saves and there is a learning curve to all of them
• Start with the first lecture and go sequentially to be sure you don’t miss topics
• For all study techniques
  • Study reps: 45-50 min “on”, 10-15 min “off” (see below)
  • Skim before lecture (assigned readings, ppts, syllabus, etc)
    • SKIM to familiarize yourself with how to spell new words and the general outline/concept of the lecture – this is not learning time
  • Attend > stream lecture and actively listen by taking notes, drawing pics, writing qs, etc.
  • Take a lunch break after lectures to get good nutrition, socialization and to recharge
• Techniques for LEARNING
  • Mind maps
  • Review notes with ppts, syllabi and text book and create a condensed 1 page review
  • Rewatch the lecture while condensing notes and focusing on main points
  • Flash cards of high yield material
  • Single page flow chart of material
• Techniques for REVIEW
  • Practice questions (online, review BRS books)
  • Small group discussion, lecture by lecture (max 4 ppl)
  • Small group quizzing of lecture material
  • Peer or upperclassman tutoring

Study Reps: 45-50 min “on”, 10-15 min “off”

• “ON”
  • Close email, g-chat, FB, other distractions, put phone on vibrate/silent
  • Set an alarm and STOP studying when it goes off
  • Write down other tasks that come to mind on a sticky note but do NOT stop studying to do them (ex: reply to email, wash dishes, make a snack, look-up question from another lecture, chat with nearby friends, etc.)
    • These tasks can be done during your “off” period
    • You will be amazed at what distracts you and feels “urgent” while studying, but there is almost NOTHING that can’t be put off for <45 min, including perez hilton
  • Don’t be frustrated if the first 15-20 min (or more) feel “wasted” bc you can’t focus – this is NORMAL and the time from sitting to focused productivity will decrease as you adjust to a daily routine (the same as exercising)
• “OFF”
  • Set an alarm
  • Reward time! NO STUDY RELATED ACTIVITIES!
  • Grab a snack, read a NYT article, catch up on the FB developments (OMG, so much happened in 45 min!!!), chat with a friend, send off a quick email, check off the list you made during  your “ON” period
  • Get up and stretch, walk around for a couple min – it’ll wake you up, get you out of your “study zone” (wherever  you are working)
  • Congratulate yourself on sticking to your study schedule and breaks
  • Relax and don’t worry about how much time you have/not spent studying, let the alarm clock guide you rather than checking your watch constantly

3. The Refinement

• What works for others may or may not work for you – don’t be discouraged!
• Study methods evolve as you discover what sticks best in your own head
• New topics/blocks may require different approaches
• At the end of the week or block, reflect on what worked well (timing, setting, method)
  • Adjust study methods to what works best for you – but remember, DILIGENCE and CONSISTENCY are king & queen
• Exam results not reflective of your efforts?  Ask for help! Professors, upperclassmen, mentors and strong peers can enhance your study skills.
• STUDYING is STUDYING – it is never wasted.

4. The Balance

• All work and no play makes a miserable and burned out student, resident and physician
• Set aside at least 1 hour as sacred for meeting your personal needs (NOT chores)
  • Examples: exercise, cooking a nice meal, calling friends and family, reading a great book, prayer or meditation
• Sleep on a schedule: go to bed and get 7-9 hrs of sleep every night, your brain needs that time to literally build memory
• Eat well: again, your brain and body need good protein to build synapses for memory, carbohydrates for fuel to burn while studying, and plenty of water to keep you going in the Houston heat
• Break up your week: take Sat. afternoon/evening off for fun activities with friends/family (movies, restaurants, dancing, bars, parties…), sleep in Sunday morning and have time for yourself and your personal development (reading, writing/journaling, church, chats with significant other)
• Schedule it: if we write it, we do it.  Use your gmail calendar, phone app, planner, etc. and plot out your week including your studying, exercise, family/friends and other activities.  It will give you a sense of control over your life as you plan your days, rather than your days ruling you.

5. The Non-Science Major

• You’re not alone – great physicians come from a variety of backgrounds!
• You may play catch-up at first, but you undoubtedly can succeed
• Writing and theoretical dissection of literature/theory/philosophy/art will be applicable in medicine – but basic sciences throws you back to the forgotten days of multiple choice exams and memorization.  Dusting off those skills and learning to study for regurgitation/application rather than creation may take some time, so don’t despair if you are spending longer in the library than the Bio-E major.
• Link up with a science-major classmate who is good at identifying high-yield material AND explaining it.
• Contact the upperclassmen study tutors – many of us had limited science exposure starting med school (“Wait, is it 2 livers or 2 kidneys – I’m not really sure?” – General Surgery Bound MS 4) and more than succeeded — but we’d love to make that transition easier for you!

For more study strategies for first years, check out Wellness Rounds.